Just Learned Mom Has a DNR

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Peaceplz

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Just learned after Mom’s hospitalization that she has a Do Not Resuscitate order which she initiated after our Father’s death. She is in very good health now and my first thoughts were ambivalent, but I recognize one day this will likely be a decision that will include our family. What is the Church’s POV on this?
 
Do you know if she also did a living will? In a living will, you make your wishes known as to the level of care you will receive if you aren’t able to make decisions. It will include feedings, hydration, level of pain management and also, a DNR for if her heart stops.

I won’t comment on the catholic question but I do know the church has procedures that it requires and those it allows. You should probably talk with a Priest and your mother…possibly all together?
 
From what I remember during my hospice volunteer training, DNR’s are only good for six months.

I could be wrong, or it’s just law here in my state
 
We are not required to allow extraordinary means. It is perfectly moral to have a DNR.

The best advice is to have good conversations about what each of you want/don’t want. Then, your mom needs to give someone Medical Power of Attorney. That designee is to be familiar with her wishes. This is far superior to any “living will”.

Also, talk about her arrangements. Get on file with the parish how she wants her Funeral Mass, Vigil Service, etc. She can pick out the readings and the songs now, that way you do not have to agonize over it when she goes.
 
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DNR simply means that measures will not be taken if her heart stops. She will and can definitely receive full treatment for anything otherwise. If she did not indicate DNI, then it means she can even be intubated if necessary.

To be honest, as a nurse, it truly irritates me when family members come along and decide against the wishes of the patient and change them from a DNR to a Full Code. Why should that be a decision you get to make for her later, knowing full well she wants to be DNR? When this occurs, it’s never about what is best for the patient, it’s always about the inability of the family members to let their loved one die a natural death because they are in denial (or worse motivations).

CPR is brutal, does not guarantee one can be brought back, and it does break ribs. Best case, you’ll bring her back, but she’ll be in very bad shape with a worse quality of life than she started with before she coded. Worst case, your mother’s last moments of life will be brutal, painful, and not at all peaceful. Some people are coded multiple times. It’s a horrible way to go.
 
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CoffeeFanatic said:
To be honest, as a nurse, it truly irritates me when family members come along and decide against the wishes of the patient and change them from a DNR to a Full Code
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I so agree coffee. I believe it’s her body her choice but I also feel the same regarding other practices that go against the Church’s opinions. Appreciate your detail and yes I will have to talk more with her about this. She is very devout and will go with the Church I suspect.
 
My father had a heart that was failing yet decided to have bypass surgery…at the urging of my step mother…yes, I have issues with her.

My dad had DNR papers everywhere in his room. In his coat pockets, in his robe pocket, in the drawer as well as the hospital having copies. After surgery, he coded and sure enough my step mother demanded he be resuscitated, because “it only stopped a little!” He coded a second time…same thing. They knew he would code again and finally my step mother said she didn’t know what to do. The doc looked at me and I said…honor the DNR. He didn’t code again but just went into complete failure and died peacefully in his sleep…actually, a coma at that point.

I doubt my step mother realizes to this day that she put my dad through unnecessary and a painful procedure but I was so thankful she finally let me make the decision that my father had already made.

Yes, if family pushes, DNRs will be ignored. I’ve made my wishes clear to my family and my daughter has medical power of attorney because I know she can make the tough choices that my husband and son would struggle with.
 
If you have ever seen someone have their heart shocked by a defibrillator, you would understand how painful and brutal it is. I’d not wish it on my worst enemy.
 
I do not know why you deleted this because there is a whole lot of truth here.

I work in a skilled nursing facility and am a hospice volunteer. Forcing nutrients and fluids is never the way to go. If a patient is alert & oriented enough, things can/will be offered, but never forced.

Dying is a part of life, we need to make sure that we are not hindering the process for our own personal needs, which is why it is so important to have these conversations often with family members, before the actual need arises.
 
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I deleted it because I didn’t want that poster to think I was attacking them in any way. They were obviously distressed over the death of their loved one and watching someone die is hard. I think some just don’t understand the reality of what actively dying looks like, but perhaps I was confused regarding what they were saying.
 
I can honestly say, that if a family pushes me as an EMT to work their loved one, I still wouldn’t do it when a DNR is in place.

The DNR is there for a reason and it is my job to honor the DNR per the patient’s wishes. The family can be screaming in my ear, threatening me with lawsuits, etc… I am bound by the DNR and my moral code to honor the patient’s wishes.
 
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Here, the next of kin can verbally override a DNR. I am guessing this varies from State to State.
 
I believe it does, but even in that instance I would still follow the DNR.
 
I know that there are a lot of people in emergency medicine who can tell from talking to patients that they often sign DNR-type directives without knowing what they’re directing. They’ll say, “Oh, well, in that kind of case, I wouldn’t want to refuse THAT!!” If your directive says you refuse it, you’re not getting it unless you are awake to ask for it.

It is very important that people who sign advance directives talk with their physicians and the next of kin they want to make their medical decisions so they can make this decision in a very informed way. They also ought to make notes and re-visit their written instructions from time to time. Sometimes patients who lose “quality of life” are a lot less cavalier about leaving life based on “low quality” than they were when they were healthier and didn’t understand the quality that a life of limited capacity can still give.

When the patients decide what they want and can explain it very clearly, they need to explain it to everyone in the family, so that those given the duty of carrying out the orders won’t have to break this news to members of the family who only assume they know what their loved one would decide.

That being said, the Church does allow people to refuse heroic measures. Just be warned that medical professionals will honor the orders that are actually signed, not what the patient “really meant.” Know very clearly what you are asking for and think about it carefully before you put something in writing.
 
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CoffeeFanatic said:
CPR is brutal, does not guarantee one can be brought back, and it does break ribs. Best case, you’ll bring her back, but she’ll be in very bad shape with a worse quality of life than she started with before she coded. Worst case, your mother’s last moments of life will be brutal, painful, and not at all peaceful. Some people are coded multiple times. It’s a horrible way to go.
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I cannot emphasize the above enough.

Imagine if you will, you are a 98 lb person in your 80’s. You suffer from multiple chronic medical conditions, including dementia. You do not have DNR when you go into cardiac arrest. The result is a 200+ pound person climbing over you and pushing on your chest will the full force of his/her body to try to bring you back. Then they use paddles and try to shock you back. The pushing breaks multiple ribs, and the paddles cause scars. Over the course of a day, you may code multiple times and each time the same procedure is repeated. You recover but what is your quality of life as an older person with several broken ribs that take much longer to heal than a younger person would.

My mother had a DNR; one thing we found out when she broke her lip last winter…in surgery DNR doesn’t count. They don’t want to screw up their numbers. She didn’t code on the operating table (hip replacement), but she did in the skilled nursing facility a couple of days later. she was allowed to pass peacefully because she had a living will, DNR and my sister as Healthcare Power of Attorney.
 
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JanetF said:
I cannot emphasei the above enough.

Imagine if you will, you are a 98 lb person in your 80’s. You suffer from multiple chronic medical conditions, including dementia. You do not have DNR when you go into cardiac arrest. The result is a 200+ pound person climbing over you and pushing on your chest will the full force of his/her body to try to bring you back. Then they use paddles and try to shock you back. The pushing breaks multiple ribs, and the paddles cause scars. Over the course of a day, you may code multiple times and each time the same procedure is repeated. You recover but what is your quality of life as an older person with several broken ribs that take much longer to heal than a younger person would.

My mother had a DNR; one thing we found out when she broke her lip last winter…in surgery DNR doesn’t count. They don’t want to screw up their numbers. She didn’t code on the operating table (hip replacement), but she did in the skilled nursing facility a couple of days later. she was allowed to pass peacefully because she had a living will, DNR and my sister as Healthcare Power of Attorney.
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This. The purpose of a DNR is not to lower the value of a patient’s life but to preserve a patient from the kind of care that would be more of a punishment that prolongs the patient’s suffering and decline rather than a reprieve that restores some semblance of health. It is hard to have a peaceful death if your caretakers don’t have permission to allow your death to take place.
 
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A couple of years ago I was admitted for (relatively) mild pneumonia. The admitting nurse asked if I desired to be resuscitated if my heart stopped. I told her, “yes, that would be nice.” I wonder if the Hippocratic oath is still taught in medical school?
 
Without a DNR, you force the person to go through the process of dying over and over, again until they finally die and can’t be brought back.

It’s actually cruel !
 
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